The belching disorder may involve release of air from either the esophagus or stomach.
Rome II designation: aerophagia
Features of belching disorder:
(1) bothersome belching from the esophagus (supragastric) and/or from the stomach (gastric) severe enough to interfere with usual activities >= 3 day per week for last 3 months
(2) symptom onset >= 6 months ago
High-resolution manometry and ntraluminal impedance measurements can be used to distinguish supragastric from gastric belching.
The upper esophageal sphincter (UES) relaxes before the onset of antegrade airflow in supragastric belching, while in gastric belching the UES relaxes after th onset of the retrograde esophageal airflow.
Excessive belching can occur in a wide range of condtions but is most often associated with:
(1) obsessive complusive disorder
(2) bullimia nervosa
(3) acute stress
(4) encephalitis
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